Type 1 diabetes in children: What you need to know

About 1 out of every 400 children and young adults under the age of 20 will develop type 1 diabetes. Although there is no cure for the disease, there are effective treatments available to help children with type 1 diabetes manage symptoms and reduce their risk of developing complications throughout their lives.

Type 1 diabetes typically happens when the immune system attacks cells in the pancreas, reducing the organ’s ability to produce a hormone called insulin. The damage often progresses to the point where the pancreas stops making insulin entirely.

Insulin allows cells in the muscles, fat and liver to absorb glucose and convert it to energy. Without an adequate supply of insulin, glucose levels in the blood become abnormally elevated, leading to symptoms of type 1 diabetes.

Although experts still don’t fully understand why children develop type 1 diabetes, some risk factors for the disease have been identified. A child is more likely to develop type 1 diabetes if:

• They have a family member with type 1 diabetes
• They are white, especially if they have Finnish or Sardinian ancestry
• They are between 4 to 6 years old or 10 to 14 years old

Special blood tests can measure the risk of diabetes. These tests identify the presence of specific autoantibodies associated with type 1 diabetes. Early detection can help identify type 1 diabetes before symptoms occur, which gives families time to plan and prepare. For people age 8 years and older who test positive for diabetes-related autoantibodies and who have abnormal blood sugars, there is a medication available that can delay the onset of type 1 diabetes.

Signs of type 1 diabetes often develop suddenly. Some common symptoms include:

• Abdominal pain
• Abnormal thirst
• Bed-wetting in toilet-trained children
• Blurred vision
• Fatigue
• Excessive hunger (though lack of appetite is also possible, especially in younger children)
• Frequent urination
• Irritability
• Nausea and vomiting
• Rapid breathing
• Sweet-smelling breath
• Weight loss

Not all children will experience every symptom listed above. If you observe any of these symptoms of type 1 diabetes in your child, consult with your healthcare provider as soon as possible.

Healthcare providers typically begin the process of diagnosing type 1 diabetes by discussing your child’s symptoms, their health history and your family medical history. They will likely then perform a physical examination. They may collect a urine sample to test for the presence of glucose and will likely order blood work to check your child’s blood sugar levels. Your child may need to fast for a certain number of hours before having their blood drawn.

Over time, abnormally high blood glucose levels in the blood can cause damage to various parts of the body. Some potential complications associated with the disease include:

• Vision problems, such as cataracts, glaucoma and impaired vision
• Foot problems, such as pressure sores
• Cardiovascular problems, such as hypertension and heart disease
• Kidney disease
• Nerve damage, which can lead to a loss of sensation and nerve pain
• Skin problems, such as dry skin 
• Frequent infections due to immune system impairment

Although type 1 diabetes can cause serious health complications, treatment for the disease can lower your child’s risk of developing complications in the future. Your healthcare provider can develop a treatment plan for your child that may include:

• Insulin replacement therapy: Your child will likely need to take insulin daily via an injection or a pump for the rest of their lives. Insulin replacement therapy helps control blood sugar levels in people with type 1 diabetes.
• Blood glucose monitoring: Typically, a child with type 1 diabetes will need to check their blood sugar levels several times per day, either by collecting a drop of blood and putting it in a glucometer or with a continuous glucose monitor, normally worn on the upper arm. Monitoring blood sugar levels throughout the day can help you determine how much insulin your child needs to take and what foods they should eat.
• Dietary changes: Children with diabetes often benefit from limiting simple carbohydrates without fiber or nutrients, such as candy, table sugar, cookies, pastries, juices, soda and cereal. These types of foods can cause blood sugar to rise quickly and can make it harder to manage diabetes.
• Exercise: Regular physical activity can help your child better manage blood sugar levels.

As you and your child get started with a treatment plan, don’t hesitate to seek out support. Talking to a mental health professional individually or as a family or joining a support group can help kids with diabetes and their parents cope with the emotional effects of the diagnosis.

Updated December 2024.